Investigating Pseudomonas aeruginosa population structure and frequency of cross-infection in UK cystic fibrosis clinics - a reference laboratory perspective.

Autor: Kenna DTD; Antimicrobial Resistance and Healthcare Associated Infections Unit-Reference Services, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK. Electronic address: dervla.kenna@ukhsa.gov.uk., Payne Z; Antimicrobial Resistance and Healthcare Associated Infections Unit-Reference Services, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK., Lee DA; Data and Analytics, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK., Keane AM; Data and Analytics, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK., Turton J; HCAI, Fungal, AMR, AMU & Sepsis Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK., Zamarreño DV; Antimicrobial Resistance and Healthcare Associated Infections Unit-Reference Services, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK., Schaefer U; Data and Analytics, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK., Hopkins KL; Antimicrobial Resistance and Healthcare Associated Infections Unit-Reference Services, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK; HCAI, Fungal, AMR, AMU & Sepsis Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK., Meunier D; Antimicrobial Resistance and Healthcare Associated Infections Unit-Reference Services, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK; HCAI, Fungal, AMR, AMU & Sepsis Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK., Dhillon R; Public Health Wales Microbiology Cardiff, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK., Duckers J; All Wales Adult CF Service, University Hospital Llandough, CF64 2XX, UK., Speight L; All Wales Adult CF Service, University Hospital Llandough, CF64 2XX, UK., Turton JF; Antimicrobial Resistance and Healthcare Associated Infections Unit-Reference Services, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK; HCAI, Fungal, AMR, AMU & Sepsis Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK.
Jazyk: angličtina
Zdroj: Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society [J Cyst Fibros] 2023 Sep; Vol. 22 (5), pp. 894-900. Date of Electronic Publication: 2023 Jun 02.
DOI: 10.1016/j.jcf.2023.05.017
Abstrakt: Background: We aimed to describe the UK Pseudomonas aeruginosa population structure amongst people with cystic fibrosis (PWCF), and to examine evidence for cross-infection.
Methods: Variable Number Tandem Repeat (VNTR) typing was performed on 4640 isolates from 2619 PWCF received from 55 hospital laboratories between 2017 and 2019. A combination of whole genome sequence (WGS)-based analysis of four clusters from one hospital, and epidemiological analysis of shared strains in twelve hospitals evaluated cross-infection.
Results: Of 2619 PWCF, 1324 (51%) harboured common clusters or known transmissible strains, while 1295 carried unique strains/those shared among small numbers of patients. Of the former, 9.5% (250 patients) harboured the Liverpool epidemic strain (LES), followed in prevalence by clone C (7.8%; 205 patients), cluster A (5%;130 patients), and cluster D (3.6%; 94 patients). WGS analysis of 10 LES isolates, 9 of cluster D and 6 isolates each of cluster A and clone C from one hospital revealed LES formed the tightest cluster (between 7 and 205 SNPs), and cluster D the loosest (between 53 and 1531 SNPs). Hospital-specific shared strains were found in some centres, although cross-infection was largely historical, with few new acquisitions. Fifty-nine PWCF (2.3%) harboured "high-risk" clones; one ST235 isolate carried a bla IMP-1 allele.
Conclusion: Of 2619 PWCF who had P. aeruginosa isolates submitted for VNTR, 51% harboured either common clusters or known transmissible strains, of which LES was the most common. Limited evidence of recent patient-to-patient strain transmission was found, suggesting cross-infection prevention measures and surveillance effectively reduce transmission.
Competing Interests: Declaration of Competing Interest None of the authors have had any conflicts of interest to declare relating to this study.
(Copyright © 2023. Published by Elsevier B.V.)
Databáze: MEDLINE
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